Individual
MOHAMMAD TARIK ALAM FIROZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
763 S NEW BALLAS RD, SUITE 265, SAINT LOUIS, MO 63141-8712
(314) 292-7305
(314) 292-7304
Mailing address
763 S NEW BALLAS RD, SUITE 265, SAINT LOUIS, MO 63141-8712
(314) 292-7305
(314) 292-7304
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
036114762
IL
207RG0100X
Gastroenterology Physician
Primary
2008030945
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200612520A
—
OK
Enumeration date
01/11/2006
Last updated
12/09/2016
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